Asherman's syndrome overview

Jump to navigation Jump to search

Asherman's syndrome Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Asherman's syndrome from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Asherman's syndrome overview On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Asherman's syndrome overview

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Asherman's syndrome overview

CDC on Asherman's syndrome overview

Asherman's syndrome overview in the news

Blogs on Asherman's syndrome overview

Directions to Hospitals Treating Asherman's syndrome

Risk calculators and risk factors for Asherman's syndrome overview

Editor(s)-in-Chief: Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Canan S Fornusek, Ph.D.; Associate Editor-In-Chief: Saud Khan M.D.

Overview

Asherman's syndrome, also called "uterine synechiae" or intrauterine adhesions, presents a condition characterized by the presence of scars within the uterine cavity.

An artificial form of Asherman's syndrome can be surgically induced by endometrial ablation in women with excessive uterine bleeding, in lieu of hysterectomy.

Historical Perspective

The Israeli gynecologist Joseph Asherman is credited with describing and characterizing the disease, hence it is called Asherman syndrome.

Classification

Classification of Asherman's syndrome takes into account the amount of functional endometrium present, the menstrual pattern, obstetric history, and more recently the location and severity of adhesions inside the uterus. There is no data showing superiority of one system over the other.

Pathophysiology

Asherman syndrome most often is the result of vigorous scraping and damage to the basal layer of the endometrium during a dilation and curettage, which may be done for a variety of reasons. It may also occur after delivery, especially if there is uncontrolled hemorrhage, or after the elective termination of a pregnancy. Less often, it is due to sampling for endometrial cancer, or removal of endometrial polyps. It may also occur after surgery to remove uterine fibroids.

Causes

Asherman's syndrome is most commonly linked to obstetric procedures that cause abrasion of the basal layer of the endometrium. Other causes include caesarian sections, infections or pelvic radiation therapy.

Intrauterine devices have not been linked to Asherman's syndrome.

Differentiating Asherman's Syndrome from other diseases

Asherman Syndrome must be differentiated from other conditions that may cause amenorrhea and pregnancy loss, and may cause infertility.

Epidiology and Demographics

Asherman's Syndrome may occur in up to 13% of women undergoing a termination of pregnancy during the first trimester, and 30% in women undergoing a dilation and curettage (D and C) after a late spontaneous abortion. Structural placental abnormalities and previous procedures done in the uterus increase the risk.

Risk Factors

The strongest risk factors for developing Asherman Syndrome is previous obstetric curettage procedures and infections.

Screening

No screening guidelines exist for Asherman's Syndrome.

Natural History, Complications and Prognosis

Asherman's syndrome typically occurs after a triggering event such as an infection or a procedure, and is a cumulative process which may lead to infertility. Damage to the uterine cavity may also cause pain, congestion and endometriosis.